FTFA: Today Jim's grieving family have questioned why he had to die before medics could realise the dangers - six years after doctors in Australia highlighted the risks.

For fark sakes. They're Doctors. Not Medics. Medic is slang for either a Military Corpsman/Healthcare Specialist, or an EMT/Paramedic in the civilian world.

Paramedics don't perform laser surgery. We lop off limbs that have been trapped under tons of concrete for more than three hours, place an occasional chest tube, and (hopefully never) cut a throat open to put a tube in someone's trachea.

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FTFA:"He coughed up a massive clot of blood and started to gush like a fountain.

"He was hysterical and ran out into the garden, panicking and scared, saying 'I'm going to die' and 'Help me'." An ambulance was called, but by the time paramedics arrived Jim's heart had already stopped. He was taken to Newcastle's Royal Victoria Infirmary where he was pronounced dead.

So either he had an esophageal varice rupture, or he had an aortic dissection of some kind. I'm sad this guy died, but if he had throat or esophageal cancer, that's one of the expected complications of it. There's really nothing in the article that points fault to the Docs like submitter claims, other than the family mad that "no one told them the risks"

In reality, however, there's NOTHING that can be done for this other than being on an OR table when it happens. In the field, Diesel Boluses to a V8 engine combined with Large bore IV or IO access and lots of fluids to keep their systolic around 90mmhg are the only way to even get them somewhere alive, where hopefully GI is setting at the bedside with an endoscope and a banding tool to stop the bleed. If it was an aortic dissection, he could have it happen setting inside of a university hosptial, and still die before he made it into the OR - in fact, active dissection is one of the reasons they'll crack your chest in the ER suite.

Even then, fluids are only going to buy short amounts of time. IV Crystaloids like Normal Saline and LR dilute clotting factors, and thin oxygen carrying blood out without replacing red blood cells or plasma proteins.

Not a good way to go. It was bad enough when my angiogram incision re-opened about 4hr after the procedure as I carefully swung my legs down off the bed, but at least I could staunch it, and help came within seconds. It was simultaneously messy, scary and bizarrely impressive.

When I was a young teenager, my grandfather was suffering through a multitude of cancers, and had already been given just a few months. It was my March break from school, and I went out to visit my grandparents. In the middle of the night I was woken up by a lot of banging, rushed out of my bedroom to see my grandfather lurching down the hallway in a panic gushing blood from his mouth, much like the guy in the article and trying to speak.

It was and still is the most horrifying thing I've ever seen, more blood than I thought was possible, and the image always sticks with me. He died that night on the floor of the washroom, and I remember most of us going in the car behind the ambulance, even though at that point it was pretty much over. My uncle stayed behind to clean so my grandmother wouldn't have to deal with it. I have no idea how he managed to do that.

I really pity the family, especially those who had to see it happen (though he really should have been taken to a doctor when the swelling appeared). Nobody should have to watch a family member or friend die like that.

mcwehrle:I'm not sure why you are so intent on making this an issue. Oncologists(not classified as a surgical position) or other "Medics" actually can and do perform surgery. Just because your verbal spanking of a UK paper using a UK term properly was just a bit off mark, it's ok. No one is perfect.

Have a lovely day.

My point was that, in common modern vernacular, it's rare to non-existant (especially in the United States) to hear a doctor called a "medic". It's more commonly used as slang for 68Ws/Corpsmen (what's the UK Equivilent?) or EMTs.

mcwehrle:Dude, *I* live in Illinios, have all my life, and even *I* knew that "medic" was a UK term. Made more glaringly apparent by that being a UK news article.

Your back yard, do you ever look past it?

Even according to your own definition it would be incorrect usage. Medic is non-surgical, right? A "Medic" wouldn't be using a laser scapel to excise a tumor and cauterize the medusa of blood vessels supplying it, would they?

Also, I like my back yard. I can see Russia from there, don'tcha know.

TheBigJerk:A question though; while there is no way he would have survived once he hit the "fountain" stage, but I was under the possibly-mistaken impression he would have had a better chance of not throwing that clot if he had been under observation instead of sent home immediately.

Not necessarily. The problem wasn't that he "threw a clot", like in a DVT or a Stroke. The problem is that either one of those blood vessels that were cauterized opened up, a part of the tumor broke free and the medusa of blood vessels that supplied it started bleeding, or he had an expected complication of throat/esophageal cancer - like an esophageal varicee, rupture. Throat and mouth cancer patients are nightmares to manage - their anatomy is all jacked up to begin with, and you can't rely on there being normal landmarks to base your airway management from, in addition to any bleeding that's going on.

BronyMedic:There's really nothing in the article that points fault to the Docs like submitter claims, other than the family mad that "no one told them the risks"

Smart money says they signed 1 to 3 consent forms which said, "I have read and understand..." those risks, as well as all the other risks.

A question though; while there is no way he would have survived once he hit the "fountain" stage, but I was under the possibly-mistaken impression he would have had a better chance of not throwing that clot if he had been under observation instead of sent home immediately.

Did you have something to add, or did you think that you needed to say something nonsensical and hit add comment?

mcwehrle:Medic is a general term for a person involved in medicine; a physician, medical student, or military medical corpsman. In the UK, the term "medic" amongst doctors indicates that someone has followed a "medical" career path accredited by the MRCP such as cardiology or endocrinology. This is in contrast to a surgical branch of specialisation in postgraduate professional training.

So it's kinda like how you guys put "ae" in everything, and how you guys have Tea and Crumpets every morning at 10?

EbolaNYC:I had a more minor incident lik this when I got my tonsils out at age 24. The wound came open and I had to be taken back to the OR, and on the way there, I spit out a coffee cup full of blood.

A little scary but it wasn't a fountain, just a slow leak. Gross.

Me too. The scar didn't close and a giant clot formed. I coughed and wham. Perk? Kaiser takes you first when you have an airway bleed.

"There was no dignity in his death. He knew he was dying and had to stand and watch it happening,"

We have a rare survivor of an aortic dissection (not in a hospital) on Fark: http://www.fark.com/comments/299811/2001951#c2001951.

Just curious, but what is the difference between an aortic dissection and an aortic aneurysm?

An aneurysm is just a weakened area of a blood vessel that is bulging out. It can be in any area of the body with an artery or arteriole. Not just the abdomen, chest or brain.

Dissection means that aneurysm has ruptured and is bleeding out into the visceral cavity and organs surrounding it.

Aortic Arch Dissections are rarely survivable unless they're distal to the arch. You literally lose your entire blood volume into your mediastinal, pleural, and pericardial areas in a matter of seconds, and you lose coronary perfusion if it's close to the aortic semi-lunar valve.

Abdominal Aortic Aneurysms are more survivable, but still very deadly. The best place to have one is close to the renal artery branch, because the retroperitoneal cavity can tamponade off the artery for a short while.

Dissection is an "OH CHRIST, OR NOW" moment. Aneurysms, especially if small, can be treated medically.

"When he was discharged on April 8, which was a Sunday, my uncle noticed he was coughing in the car on the way home."He went to bed because he was quite tired, then got up and drove mum to work the next day."My sister Ashlee came home in the afternoon and a friend was there who had popped to see him."She could see his neck was really swollen, like he had tonsillitis, but at the time he didn't think anything of it.

I'm sorry, but if the day you're discharged from the hospital after having major throat surgery you notice that you're having throat-related problems and choose to do nothing about it, you're a f*cking retard and there's really not a hell of a lot that can be done to prevent Darwin from visiting.